Analyte concentration determination in physiological samples is of ever increasing importance to today's society. Such assays find use in a variety of application settings, including clinical laboratory testing, home testing, etc., where the results of such testing play a prominent role in the diagnosis and management of a variety of disease conditions. Analytes of interest include glucose for diabetes management, cholesterol for monitoring cardiovascular conditions, drugs for monitoring levels of therapeutic agents or identifying illegal/illegal levels of drugs, and the like. In response to this growing importance of analyte concentration determination, a variety of analyte concentration determination protocols and devices for both clinical and home testing have been developed.
In determining the concentration of an analyte in a physiological sample, a physiological sample must first be obtained. Obtaining and testing the sample often involves cumbersome and complicated procedures. Unfortunately, successful manipulation and handling of test elements, lancing members, meters and the like is to a great extent dependent on the visual acuity and manual dexterity of the user, which in the case of people with diabetes is subject to deterioration over the course of the disease state. In extreme cases people that have significant loss of sight and sensation, testing procedures can become significantly difficult and requires additional assistance from ancillary devices or personnel.
A typical procedure involved with making a glucose measurement involves the following actions or steps (but not necessarily in the order given):                1) removing supplies from a carrying case,        2) removing a lancing device loading cap or door,        3) removing and disposing of an old lancet form the lancing device,        4) inserting the lancet in the lancing device,        5) twisting off a protective cap from the lancet,        6) replacing the lancing device cap.        7) cocking the lancing device,        8) opening a test strip vial/container,        9) removing a strip from the container and inserting or interfacing it with a meter,        10) holding a lancing device to the skin,        11) firing the lancing device,        12) lifting the lancing device and setting aside,        13) extracting a sample,        14) applying sample to the test strip and getting results,        15) disposing of the test strip,        16) cleaning the test site, and        17) returning supplies to the carrying case.Sometimes fewer steps are involved. One manner of reducing the number of actions is by integrated devices set to combine multiple functions.        
In this regard, certain test strip dispensers are configured to both store and advance successive test strips upon actuation. Examples of such devices are presented in U.S. Pat. Nos. 5,510,266; 5,575,403, 5,797,693 and possibly in PCT Publication WO 01/63272. In addition some dispensers also include meter functionality. Examples of such of systems that integrate test strip meter and dispenser combination functions are disclosed in U.S. Pat. Nos. 5,736,103, 5,757,666 and PCT Publication WO 99/44508. Furthermore, the device described in WO 01/23885 includes all of the above features, plus a receptacle to receive spent test strip elements that are cut off of a continuous roll of the same.
Another class of devices designed to decrease the number of steps required in test strip use includes automatic or semi-automatic lancing devices. U.S. Pat. No. 6,228,100 discloses a structure configured for sequential firing of a number of lancets, one at a time, in order to eliminate the requirement that a user remove and replace each lancet individually before and after use.
The device disclosed in U.S. Pat. No. 5,971,941 attempts to combine the functionality of each of the preceding classes of test strip devices. In effort to provide an “integrated” system for sampling blood and analysis thereof, it includes a magazine of test strips, test strip advancement and dispensing features, a meter with a display and an automated lancing mechanism all housed with a single box. While presenting some measure of advance in user convenience, the test strip and lancing features are removed from each other causing the user to take two steps in lancing and transferring sample to a test strip. Furthermore, the device includes no provisions for used test strips.
While certain combination test strip and lancing systems that do not require that a subject to move the device relative to the sample site in use (e.g., the systems described in U.S. Pat. Nos. 6,352,514; 6,332,871; 6,183,489; 6,099,484; 6,056,701 and 5,820,570), some of these systems are quite complex and, consequently, either difficult to operate or costly to produce. In addition, some involve changing-out spent test and/or lancet members one-at-a-time. This is true with respect to the systems described in U.S. Pat. Nos. 6,027,459; 6,063,039; 6,071,251 and 6,283,926 as well as for certain embodiments disclosed in PCT Publication WO 01/64105.
However, another embodiment presented in that reference provides for multiple lancet/sensor pairs that only need to be changed out after the disks including each are spent. An exemplary number of a dozen such radially-oriented pairs is provided. PCT Application entitled “Analyte Measurement,” claiming a priority of Dec. 19, 2000 from GB 0020929.4 also discloses a meter including a multiple sensor/tester element. Fluid extracted from a subject by a microneedle at a common entrance port is selectively switched between a number of microchannels by means of electro-osmotic pumps and hydrophobic gates. The present invention is distinguished from each of these inventions in terms of its modular use of combination test strip and sensor elements, in which unexposed items may be sealed-off from contamination, and possibly provided in greater number, as well as in the simplicity of the present invention which preferably involves mechanical movement for sample acquisition and handling.
Of course, such advantages may be present in systems according to the invention in various degrees. It is intended that, in one way or another, the invention is of assistance in reducing barriers to patient self-monitoring and therefore result in improved outcomes in the management of disease, such as diabetes.